Orthopedic device

ABSTRACT

An orthopedic device has a main body panel including a longitudinal length with a curved cross-section, and opposed lateral and medial sides. A posterior panel is secured to the lateral and medial sides of the main body panel, and is sized longitudinally shorter than the main body panel in a non-stretched condition. The posterior panel is secured to the main body panel in a pretensioned condition and spans the longitudinal length of the main body panel along the lateral and medial sides thereof.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of priority from U.S. provisionalapplication No. 61/487,478, filed on May 18, 2011, and U.S. provisionalapplication No. 61/426,188, filed on Dec. 22, 2010, the entirety ofthese provisional applications being incorporated herein by reference.

FIELD OF THE DISCLOSURE

This disclosure relates to an orthopedic device, and more particularlyto a knee brace having at least a posterior contour adapted to a naturalcontour of a leg, a plurality sections having different pretensioning,and a patella buttress for supporting a patella.

BACKGROUND

Various orthopedic devices have been developed and are available forstabilizing and protecting injured or infirm knees. Many of thesesupports are made from flexible resilient materials that are arranged tostretch over the knee and provide support by compression about the kneeof the wearer.

Certain problems exist with many known devices in that some of thedevices are formed from closed cell elastomer materials that have poorthermal conductivity and are unable to absorb or wick perspiration fromthe area supported by the device. These devices also have the tendencyto bunch up over the popliteal region of the knee when the leg isflexed, and have seams over the popliteal region causing irritation tothe wearer.

Although past efforts have been made to remedy these problems,commercially available devices typically fall short in avoiding theproblems. As a result, wearers of the devices are often reluctant toconsistently wear the devices, which can lead to future complications orcontinued discomfort.

Notably, many of these known devices provide uniform circumferentialcompression about the knee when the device is stretched. The compressionapplied by the device can be painful to the wearer if areas of the legand knee are sensitive to pressure.

Some of the known devices include a front central opening that allow forthe wearer's patella or kneecap to project. The front central openingrelieves pressure that would otherwise be exerted on the patella,particularly when the knee is bent or in flexion. These devices mayinclude a pad or buttress located about the front central opening so asto provide a restraining force to the patella and additional support,such as preventing lateral or medial displacement of the patella in thefemoral groove.

Despite known solutions, many devices fail to maintain the patella padin a proper position on the support so the opening or pad can preventpatella displacement.

Accordingly, there is a need for a knee brace that at least providesmeans for stabilizing and supporting the patella, as well as providemeans for maintaining the brace in proper position on the leg in acomfortable manner so as not to interfere with the normal use of theleg.

SUMMARY

In accordance with the various exemplary orthopedic device embodimentsof the disclosure, a knee brace is provided having a highly breathableconstruction for increasing patient comfort without sacrificingdurability or compression of the knee brace. The knee brace can controlligament extension and flexion, and may be used to treat strains,sprains or instabilities of the anterior, medial, lateral and posteriorcollateral ligaments. The knee brace may also be designated forpost-operative care following meniscal repairs and other reconstructivesurgeries of the knee.

The various knee brace embodiments provide multiple features arranged totreat medical necessities with measurable consequences. In one example,the knee brace employs a three-dimensionally shaped contrast fabricbehind the knee joint that reduces bunching, which in turn allows forgreater comfort and conformance to the leg, as well as maintaincompression about the leg. The contrast fabric provides for soft-tissuecompression so as to offer edema control and reduce swelling.

The contrast fabric is preferably located on the posterior aspect of theknee brace, and eliminates the necessity of cutting out a section at thepopliteal portion of the knee or brace, and allows for bettercompression over known braces having a popliteal cut-out. In particular,the knee brace is arranged to stretch in extension and relax back to anatural or predetermined shaped in flexion, thereby minimizing poplitealbunching (along the posterior side of the knee) that causes skinirritation.

Various materials and combinations thereof are employed in embodimentsof the knee brace to provide for an intimate fit, reduce heat retentionand sweat, and allow application of the knee brace for application fromthe left or right sides of the leg. These benefits are achieved by theselection of particular materials including those having breathable andquick-drying properties, stitching patterns, and pre-tensioning ofcertain fabric sections.

In another feature, the knee brace may include rigid uprights connectedto the hinge that are malleable allowing for enhanced medial-lateralstability in a knee brace. The malleable rigid uprights also providepatient perception of enhanced stability of the knee brace. Someembodiments include pull tabs for facilitating donning and doffing ofthe knee brace, as well as easy fitting and maintaining the location ofthe hinge. Various pocket constructions are used to house the uprightsand may also include the hinge as well.

In yet another feature, the knee brace may include dual lower cruciatestraps that enable fine-tuned control of the anterior-posterior hingeplacement and cinch the knee brace above the gastroc to reduce migrationof the brace over the leg. Additionally, the knee brace includes areversible strapping system by way of individual straps for both theanterior and posterior aspects of the leg. This enables the brace to beset up to pull laterally-to medially, medially-to-laterally, or acombination of both, depending on specific treatment objectives of thewearer of the knee brace.

Certain patella buttresses may be used in combination with embodimentsof the knee brace. According to various embodiments described herein,the buttress may employ various textile combinations having differentproperties and locations which lead to improved support about thebuttress. Certain patella buttresses are located on the exterior surfaceof the knee brace, as opposed to on a posterior surface as in knownbraces. These embodiments include the concept of providing anintermediate layer lacking stretchability so as to prevent excessivestretching of the buttress and effectively yielding to the movement ofthe wearer without providing adequate support.

Alternatively, patella buttress embodiments may be arranged to direct abuttress toward the knee or be arranged with a combination of materialsand stitching types to minimize or enhance localized stretching of thepatella buttress and particularly direct the buttress.

In yet another embodiment, the patella buttress may be securable aboutan opening formed by the knee brace. The patella buttress is configuredand dimensioned so that it can be removably mounted at a plurality oflocations about the circumference of the opening, thereby allowing thewearer to place the patella buttress at a location best suited forsupporting an individual wearer's patella.

BRIEF DESCRIPTION OF THE DRAWINGS

The numerous other advantages, features and functions of embodiments ofa knee brace and orthopedic concepts will become readily apparent andbetter understood in view of the following description and accompanyingdrawings. The following description is not intended to limit the scopeof the knee brace and orthopedic concepts, but instead merely providesexemplary embodiments for ease of understanding.

FIG. 1 is a rear elevational view showing a knee brace embodimentincluding certain features of the orthopedic device.

FIG. 2 is a side elevational view showing the knee brace of FIG. 1.

FIG. 3 is a front elevational view showing the knee brace of FIG. 1.

FIG. 4 is a perspective view showing size relationships of a main bodypanel and a posterior panel in the knee brace of FIG. 1.

FIG. 5 is a sectional view showing an embodiment of a patella buttressin the knee brace of FIG. 1.

FIG. 6 is a schematic view showing an inner surface of the patellabuttress of FIG. 5.

FIG. 7 is a cross-section view taken along line VII-VII of the patellabuttress of FIG. 5.

FIG. 8 is an exploded view of another embodiment of a patella buttressfrom the inside surface descending to the outside surface.

FIG. 9 is a rear, inside surface view of the patella buttress of FIG. 8.

FIG. 10 is an outside surface view of the patella buttress of FIG. 8without the innermost layer and the buttress.

FIG. 11 is a cross-sectional view taken along line XI-XI in FIG. 9.

FIGS. 12A-12D show an embodiment of the knee brace wherein the patellabuttress is adapted to be arranged at a plurality of orientations alongan interior surface of and about an opening of the knee brace.

FIG. 13 is a side elevational view showing another embodiment of a kneebrace having a hinge secured within a pocket.

FIG. 14 is a front elevational view showing another embodiment of a kneebrace with a set of hinges having portions exposed on the outer surfaceof the knee brace.

FIG. 15 is a second side elevational view showing the knee brace of FIG.14.

It should be noted that the drawing figures are not necessarily drawn toscale, but instead are drawn to provide a better understanding of thecomponents thereof, and are not intended to be limiting in scope, butrather to provide exemplary illustrations. It should further be notedthat the figures illustrate exemplary configurations of a knee brace,and in no way limit the structures or configurations of a liner thereofaccording to the present disclosure.

DETAILED DESCRIPTION OF VARIOUS EMBODIMENTS A. Overview

Numerous knee brace embodiments and components for use therewith aredescribed herein, with particular focus given to supports and componentsdirected to the knee joint and surrounding areas. The knee braceembodiments may serve in protective, preventative or remedialcapacities. While the knee brace is described within the context ofpreferred embodiments that are directed to supporting a knee joint, manyof the features described herein may be extended to other supports andcomponents that bear or secure other joints and body parts, such as thewrist, elbow, shoulder, ankle and neck.

The knee brace embodiments and components for use therewith may bedimensioned to accommodate different types, shapes and sizes of humanjoints and appendages. These embodiments may be modified to orientprincipal forces exerted by the leg.

As is well understood, the primary movements of the knee compriseflexion, i.e., rearward rotational movement of the tibia relative to thefemur, and extension, i.e., forward rotational movement of the tibiarelative to the femur.

For explanatory purposes, each knee brace or component thereof describedherein may be divided into sections which are denoted by generalanatomical terms for the human body. Such anatomical terms are providedto distinguish various elements of the leg support embodiments from oneanother, but which are not to be considered to limit the scope of theinvention.

The terms “proximal” and “distal” generally refer to locations of theknee brace that correspond to the location of leg relative to the pointof attachment of the leg to the body. The terms “upper” and “lower” maybe used in combination with “proximal” and “distal” to connotegradations in location of “proximal” and “distal.” The location at wherethe support corresponds to the knee joint is used herein to generallydelimit the proximal and distal, or upper (U) and lower (L) sectionsspaced by a center section (C) of the knee brace.

The embodiments of the leg support can also be considered to fall within“anterior” and “posterior” sections by an anterior-posterior plane. Theanterior-posterior plane generally corresponds to the coronal or frontalplane of a human leg which lies along the central longitudinal axis of abody. A posterior side or element is therefore located behind thisanterior-posterior plane, whereas an anterior side or element is locatedin front of the anterior-posterior plane.

The terms “inwardly” or “inner” commonly used herein to distinguish theside of the leg support that may be directed to the posterior side ofthe support and specifically adjacent to the leg of the wearer of thesupport. On the other hand, the term “outwardly” or “outer” are used todenote the side of the support that is opposite to the inwardly side.

The terms “medial” and “lateral” are relative terms that are generallyunderstood as indicating location near the midsaggital plane or midline.Therefore, elements that are located near the midline are referred to as“medial” and those elements that are further from the midline areconsidered to be “lateral.” The term “central” is used to denote thearea along the midline including portions of the medial and lateralregions.

B. Various Embodiments

FIGS. 1-3 illustrate an embodiment of the knee brace 10. The knee brace10 includes a main body panel 12 and a posterior panel 14. The posteriorpanel 14 is secured to the main body panel 12 along its longitudinallength by longitudinal seams 16 such as inner and outer parallel seamslocated on both lateral and medial sides of the knee brace. The mainbody panel and the posterior panel together form an elongate, tubularbody adapted to anatomically conform to the thigh, knee and calf, withthe main body panel generally forming a curved or arcuate cross-section.The brace flares at the thigh or upper portion (U) of the brace andtapers below the knee or central (C) to the calf or lower portion (L).

The knee brace resembles a leg in extension when in a rest or unworncondition. The posterior panel 14 is pretensioned or has greatertensioning relative to the main body panel 12 which may or may not haveany particular pretensionig. From the tension of the posterior panel 14,the knee brace has a posterior contour 32 that reflects a natural shapeof a leg in extension. By virtue of the tension of the posterior panel14, the knee brace also defines upper and lower inclined edges 22, 24,sloping downwardly from the anterior aspect of the knee brace to theposterior aspect of the knee brace.

The posterior panel 14 defines upper and lower portions 28, 30 thatspace the entirety of opposed sides of the main body panel 12 from oneanother. The upper and lower portions 28, 30 narrow toward the upper andlower edges 22, 24 from a larger center portion 26. The upper and lowerportions 28, 30 have a sufficient spacing width 18, 20 from the mainbody panel that allows for a portion of the posterior panel 14 to formpart of the upper and lower edges 22, 24. This spacing width 18, 20forms a clearance between opposed sides of the main body panel, andminimizes any unraveling of the stitching securing the posterior panelto the main body panel. The spacing width further eliminates anypotential pressure points by gradually and evenly distributing pressureon the posterior aspect of the leg.

The center portion 26 generally corresponds to the popliteal of awearer's knee. The configuration of the posterior panel 14 removes theneed to for a single seam located along the posterior center of thebrace and minimizes patient irritation on the popliteal area of thewearer's knee. Alternatively, the knee brace may be provided with apopliteal opening 29 that corresponds to the popliteal section of theknee brace. The popliteal opening is preferably, but not limited, to beformed by the posterior panel 14, and may have its periphery reinforcedwith stitching or other means such as an additional fabric edging so asto mitigate fraying about the opening.

The knee brace includes first and second hinges 34, 36 located onlateral and medial sides of the brace. The hinges 34, 36 have upper andlower struts 68, 70 extending from opposed sides of a hinge mechanism 66that are retained on the main body panel by upper and lower pockets 62,64. The struts 68, 70 may be formed from a malleable material, such asaluminum, that allows for some customization to the wearer's body shape,while remaining sufficiently strong to avoid bending while the kneebrace is in use by the wearer.

As depicted in FIG. 3, the hinge mechanism 66 may be adjustably securedto the main body panel 12 at fastening points 82 so that the placementof the hinge mechanism can be shifted either posteriorly or anteriorlyfor anterior-posterior placement. This allows for the hinge to be placedat a particular location, and permits some minor adjustment to securethe hinge mechanism anteriorly or posteriorly at particular locations.For example, at an initial fitting by a clinician, the hinge location isset according to the particular anatomy of the patient because the strapis locked by the hook on both sides and the patient does not have toadjust this again. This allows for repeated and consistent donning.

The brace depicted in FIGS. 1-3 is considered a long version of the kneebrace (a shorter version is found in FIGS. 8-10). The knee brace mayinclude a plurality of circumferential straps. The straps may include anupper thigh strap 38 having a strap loop or pull tab 78 for guidance, alower thigh strap 40, and a lower calf strap 44. Each of the straps maybe removable to allow for the brace to be customized to the patient fordirectional leverage.

For example, the upper thigh strap 38 is removably mounted on the outersurface of the hinge cover 62, such as by a hook and loop system, andincludes a buckle 39 at one end. The strap 38 can be reversed inorientation, meaning the direction of the pull of the strap. Thisreversible strapping system allows the brace to be set up to pulllaterally-to-medially, medially-to-laterally, or a combination of both,as exemplified in FIG. 3 by the arrows under the various straps, bymodifying the orientation of the upper thigh strap 38 relative to thelower thigh strap 40.

The brace may include separate anterior and posterior straps 41, 42located along any portion of the knee brace. For example, the brace mayhave an anterior strap 41 that extends only about the anterior side ofthe brace. The anterior strap is secured to buckles 74 located onlateral and medial sides of the brace. A posterior strap 42 extends onlyabout the posterior side of the brace, and is secured to buckles 76located on lateral and medial sides of the brace. Because the hingemechanism has anterior-posterior placement, the anterior posteriorstraps 41, 42 have fine-tuned control thereby allowing the knee brace tobe cinched above the wearer's gastroc to reduce migration.

As shown in FIG. 4, the posterior panel 14 is sized shorter than themain body panel 12 prior to securing the panels to one another. The mainbody panel 12 has longitudinal edges 84, 86 along which longitudinaledges 85, 87 of the posterior panel 14 respectively secure. The mainbody panel 12 has an affixation point 88 upon which a correspondingaffixation point 90 of the posterior panel 14 secures.

The posterior panel 14 is sewn along the longitudinal edges to the mainbody panel 12 from the upper portion 28 to the center portion 26,particularly to the affixation points 88, 90. The posterior panel 14 isthen sewn from the center portion 26 to the lower portion 30. From thisconfiguration, tension is formed in the posterior panel 14, and impartsthe natural contour 32 to the shape of a knee in a naturally bentposition. The affixation points 88, 90, serve as a point of inflectionfor the natural contour 32 about the center or knee portion of thebrace. This natural contour shape is in contrast to the conical shape ofconventional tubular braces. The tensioning of the posterior panel willalso reduce material bunching behind the knee whether the knee is inflexion or extension.

According to one variation, the material forming the posterior panel isthinner than the material forming the main body panel prior to beingsecured to the main body panel. This variation allows for a morestretchable posterior panel. According to another variation, thematerial forming the posterior panel has the same thickness as thematerial used to form the main body panel.

The posterior panel may have the same stretch properties as the mainbody panel so as to avoid sharp wrinkles behind the knee that may causeirritation. When the posterior and main body panels have the samestretch properties, the knee brace can provide a more consistent or evencircumferential compression. It follows that if the posterior panel iseasier to stretch than the main body panel, the posterior panel may tendto stretch to its maximum width before the main body panel has stretchedsufficiently to provide necessary compression.

The material used to form the main body and posterior panels ispreferably a three-dimensional double faced spacer material having acircular knit. The knit of the spacer material is linked which allowsfor a gradual stretch until there is a complete extension of thematerial and hence the brace itself. The spacer material has highbreathability that allows sweat to evaporate and heat to dissipate. Thebreathability of the spacer material provides an environmentinhospitable to bacteria growth. The spacer material moves with thebody, and does not cause unneeded resistant to range of motion. Thespacer material is preferably latex and neoprene free, and therefore thematerial may form the entire thickness of the brace without additionallayers.

The spacer material is constructed with a fine gauge yarn and has atight knit pattern leading to a smooth finish that is cool to the touchand is comfortable for wear. In many known knee braces, typicalmaterials are manufactured with thicker yarns and looser knit patternshaving a coarse texture that leads to skin irritation or discomfort.

The material construction of the main body panel and posterior panel ofthe knee brace in accordance with the embodiments herein is particularlyadvantageous in that it facilitates donning and doffing of the brace.The main body and posterior panels preferably are placed in contact withthe skin of the wearer, and there is sufficient friction to maintain thebrace against the skin of the wearer without the brace sliding off theleg.

Because the spacer material has natural compressibility, the brace ispreferably provided without additional foam padding along either theouter or inner surfaces of the main body panel. This allows for improvedbreathability over known knee braces thereby minimizing sweat and heatbuild-up, and also has improved air permeability so as to reducemoisture and bacteria accumulation.

The patella buttress is depicted in greater detail in FIGS. 5-7. Thebuttress 46 surrounds a patella opening 48 formed by the main body panel12. The buttress 46 includes an outer covering 50, an intermediate layer52 secured to an inner surface of the outer covering 50, and a buttresselement or flexible rod 56. The outer covering 50 and the intermediatelayer 52 are secured to the main body panel 12 about their inner andouter peripheral edges by a stitching (preferably a zigzag formation) toallow for some stretching of the buttress 46 relative to the main bodypanel 12. The combination of the outer covering 50 and intermediatelayer 52 forms a pocket 106 between the main body panel 12, and the rod56 is securely located within the pocket 106.

The outer covering 50 forms first and second apertures 58, 60 located onopposed sides of the buttress 46. The apertures 58, 60 allow for accessto the rod 56, whereby a portion of the rod 56 can be removed formodification. For example, in an initial configuration, the rod 56generally conforms to the shape of a horseshoe. The rod 56 can be pulledin a direction 81 from the aperture 60 and have an end portion 80severed so as to reduce its length. The rod 56 is then pulled in anotherdirection 63 toward a top portion 61 of the buttress so as to form aJ-shape. The J-shape or lateral “J” is a shape that allows for a greaterconcentration of support about the patella. From the two apertures 58,60, either side of the rod can be configured to form the J-shape.

The intermediate layer 52 has a configuration of multiple zones that arelocated about the pocket 106 of the buttress. In the illustratedexample, the intermediate layer 52 has first side zone 94, second sidezone 96 and lower zone 98. Each of the zones 94, 96, 98 is preferablyconnected to one another by a tether 100, 102, 104, and spaced by aclearance 92 that maintains the zones in proper spacing with oneanother. The zones are arranged to minimize or inhibit stretching of thelength, width, and expansion of circumference of the outer layerrelative to the main body panel.

The top portion 61 of the buttress is shaped so as to better contour andadapt to the shape of patella in order to reduce stretch of the buttress(as evidenced by the shorter tether 104 than tethers 100, 102). Thiswill reduce the stretch of the buttress so it does not bow significantlyradially outwardly and thereby better and stably hold the rod about theknee of the wearer. The rod is preferably formed from a siliconeclosed-cell sponge cord, however is may be constructed from othersuitable materials that can be used to support the patella in a similarfashion to a silicone closed-cell sponge or foam insert.

As depicted in FIG. 7, the buttress 46 forms a bulge 72 (seen also inFIG. 2) about the periphery of the opening 48, whereby a portion of theouter covering 50 and the intermediate layer 52 wraps about the rodaround the periphery of the opening 48. From this construction, theintermediate layer limits stretching of the opening 48 in order tosecurely retain the patella of the wearer. The buttress 46 graduallytapers from the bulge 72 to the outer peripheral edges 108 of the outercovering 50 and intermediate layer 52.

The outer layer is preferably formed from the same material used to formthe main body panel. The intermediate layer may be formed from amaterial that has little or no stretchability, such as a rigid textile.The lack of stretchability of the intermediate layer prevents excessivestretching of the buttress so as to prevent the buttress from stretchingtoo much and effectively yielding to the movement of the wearer withoutproviding adequate support.

For example, the intermediate layer directs the rod inwardly toward thepatella of the wearer, effectively drawing the rod toward the patelladespite movement by the wearer (as evidenced by arrows in FIG. 7). Inareas of the buttress without the rod, as shown in FIG. 7, these areasare also reinforced by the intermediate layer so as to inhibitstretching outward relative to the patella of the wearer.

In the illustrated three zone construction in FIG. 6, the intermediatelayer is configured to achieve the desired stretch properties within thebuttress. The zones are strategically located to provide a combinationof optimal stretch and direct a posterior force toward the patella incritical areas. The tethers 100, 102, 104 may allow for some radialstretching of the buttress, as depicted by arrows 100A, 102A, 104A,thereby permitting some radial adjustment of the buttress about thepatella of the wearer, whereas the zones inhibit radial stretching dueto their larger material portions, as evidenced by FIG. 6.

Variations of the stitching may be configured such that in areasincluding the stitching 65 about the opening 48, the stitching is in alooser zigzag formation in order to allow for some stretching of theopening 48, whereas the stitching 67 on the outer periphery 54 of thebuttress is tighter, whether or not it is in a zigzag configuration, soas to inhibit stretching of the outer periphery 54 of the buttress. Ofcourse, even on the outer periphery stitching 67, the tightness of thestitching may be varied if more stretching is desired, such as providinga looser stitching at the apertures 58, 60.

In another embodiment of the patella buttress, FIGS. 8-11 show analternative patella buttress 120 that allows for removal of patellabuttress from the inside of the knee brace.

As shown in FIG. 8, the patella buttress includes an inner layer 122having a horseshoe configuration oriented oppositely in direction to thehorseshoe shaped buttress 124. A fastener material 126 is removablysecurable to the buttress 124 and an interlining or intermediate layer128. An outer layer 130 forms an opening 132 that is axially alignedalong axis A-A with the inner layer 122, the buttress 124, and theintermediate layer 128. The outer layer may be a separate layer from themain body panel, or may merely be the main body panel described inconnection with the embodiment of FIGS. 1-3.

The inner layer 122 is preferably formed from a stretchable jersey typefabric, thereby allowing the buttress 124 to yield toward the knee of awearer. The buttress 124 is shaped by having a generally flat surface142 that faces the outer layer 130 or outermost surface of the kneebrace. The buttress has a rounded surface 144 that is oriented towardthe inner layer 122, and may be constructed from any suitable materialproviding compressibility, such as foam with a textile covering.

The intermediate layer 128 is preferably non-stretchable, as in theintermediate layer described above in connection to the embodiment ofFIGS. 5-7. Further, the intermediate layer 128 may be formed from orinclude an unbroken loop material 134 thereby permitting the fastenermaterial 126 to be secured thereon.

According to FIG. 9, the inside surface of the patella buttress 120 isshown generally as it would appear in the knee brace. The inner layer122 is oriented oppositely to the buttress 124 so as to form an opening146 between the intermediate layer 128 and likewise the outer layer 130and define a pocket for retaining the buttress 124 at stitching 136located on opposed sides of the opening 146.

The stitching 148 around the opening 132 is provided more tightly thanthe outer edge stitching 138 around the inner layer and the stitching136. For example, the stitching 148 may be a zigzag stitching having11-13 stitches per 3.0 cm. On the other hand, the stitching 136, 138 mayalso be a zigzag stitching having 9-11 stitches per 3.0 cm, which islooser than the stitching 148 and allows for more stretching, therebyallowing the buttress to flex outwardly relative to the opening.

In reference to FIG. 10, the intermediate layer 128 is secured to theouter layer 130 by a single needle stitch which generally preventsflexing of the intermediate layer 128. Suitable stitching may be used tosecure the intermediate layer 128 to the outer layer 130, oralternatively, the intermediate layer may be laminated or otherwiseadhered to the outer layer.

Turning to FIG. 11, the outer layer 130 has greater padding orcushioning toward the opening 132 in part due to the outer layer 130being less or not compressed at this location. The outer layer is morecompressed as it approaches the outer edge stitching 138. The buttress124 is biased toward the inside of the brace or wearer's knee, with therounded surface 144 being directed toward the inside of the brace.

From the stitching types, and the material properties of the variouslayers, the patella buttress provides ample compression about the knee,while allowing for some accommodation of stretching in certaindirections while inhibiting stretching in other directions.

The basic principles described herein in regard to using materialshaving different properties and different stitching patterns andstitches per cm may be employed in any of the aspects of the knee braceto either inhibit or enhance stretchability.

As illustrated in FIGS. 12A-12D, an alternative embodiment of patellabuttress 156 is shown that is adjustably and removable secured to aninner surface 150 of the knee brace about the circumference of a patellaopening 152 formed thereby. The border 154 has a loop material that canengage hook material located along a surface of the buttress 156. FIGS.12A-12D exemplify how the buttress 156 can be attached to the innersurface 150 of the knee brace among a plurality of orientations.Moreover, if it is not desired to include the buttress, it can be easilyremoved without significantly interfering with the remainder of thebrace. The buttress may be formed from a variety of materials such asfoam, and may include a suitable cover. It may also be trimmed accordingto the needs of the wearer.

Turning to the embodiments of FIG. 13, a short version of the knee brace200 may be provided with a hinge retainer 204 that conceals one of thelateral or medial hinges. The hinge retainer 204 includes a main pocket216 and a flap 222 that covers the proximal end (or alternatively thedistal end) of the main pocket 216. The main pocket 216 is formed so asto snugly accommodate the hinge 224.

The knee brace 200 is configured as a “wraparound” brace by beingadapted to wrap about the leg of the wearer with a wrap configuration206 having wrap tabs 208, 210 that secure to a main body 202 of thebrace 200. The strap tabs 208, 210 are located above and below the kneeof the wearer so as to provide additional circumferential tightening ofthe knee brace.

FIGS. 14-15 shows an alternative knee brace embodiment 201 of the kneebrace 200 of FIG. 12 wherein portions of the hinges 212 are exposed onthe outer surface of the brace, such as instances wherein the hinges arerange-of-motion hinges requiring adjustment. The hinges 212 are securedsimilarly as shown in connection with the knee brace embodiment 10 ofFIGS. 1 and 2. Particularly, the hinges 212 are retained by pockets 214,215, and having openings 218, 220 for receiving arms of the hinges 212.

The knee brace 201 includes a strap loop or pull tab 224 that serves thedual purposes of retaining a strap, and as a tab for assisting in thedonning of the knee brace. Particularly, the pull tab 224 does notextend or only minimally extends beyond the proximal end 226 of the mainbody 202 so as to avoid interfering or catching on any objects. The pulltab 224 may be connected to the main body 202 by zigzag stitching toallow and formed from a stretchable material to allow for somestretching as the wearer dons the brace.

It should be understood that not necessarily all objects or advantagesmay be achieved in accordance with any particular embodiment of theinvention. Thus, for example, those skilled in the art will recognizethat the invention may be embodied or carried out in a manner thatachieves or optimizes one advantage or group of advantages as taughtherein without necessarily achieving other objects or advantages as maybe taught or suggested herein.

Those skilled in the art will recognize the interchangeability ofvarious disclosed features. In addition to the variations describedherein, other known equivalents for each feature can be mixed andmatched by one of ordinary skill in this art to construct suspensionliner in accordance with principles of the present invention.

Although this invention has been disclosed in the context of certainexemplary embodiments and variations thereof, it therefore will beunderstood by those skilled in the art that the present inventionextends beyond the specifically disclosed embodiments to otheralternative embodiments and/or uses of the invention and obviousmodifications and equivalents thereof. Thus, it is intended that thescope of the present invention herein disclosed should not be limited bythe particular disclosed embodiments described above.

1. An orthopedic device, comprising: a main body panel having alongitudinal length with a curved cross-section, the main body panelhaving opposed lateral and medial sides; a posterior panel secured tothe lateral and medial sides of the main body panel, the posterior panelsized longitudinally shorter than the main body panel in a non-stretchedcondition, the posterior panel secured to the main body panel in apretensioned condition and spans the longitudinal length of the mainbody panel along the lateral and medial sides thereof.
 2. The orthopedicdevice according to claim 1, wherein the posterior panel urges a bentcontour to the posterior side of the orthopedic device.
 3. Theorthopedic device according to claim 1, wherein the material forming theposterior panel is thinner than the material forming the main bodypanel.
 4. The orthopedic device according to claim 1, wherein theposterior panel has the same stretchability as the main body panel. 5.The orthopedic device according to claim 1, wherein the posterior panelhas upper, lower and center portions, the center portion having agreater width than the upper and lower portions.
 6. The orthopedicdevice according to claim 5, wherein the upper portion is wider than thelower portion of the posterior panel.
 7. The orthopedic device accordingto claim 5, wherein the center portion of the posterior panel is securedto a center portion of the main body panel.
 8. The orthopedic deviceaccording to claim 1, wherein longitudinal seams secure the posteriorpanel to the main body panel, the longitudinal seams being locatedoutside of the center portion of the posterior panel generallycorresponding to the popliteal area of a wearer's leg.
 9. The orthopedicdevice according to claim 1, wherein when worn on a leg of a wearer, theposterior panel is in a stretched condition relative to the main bodypanel when a leg is in extension.
 10. The orthopedic device according toclaim 1, wherein material forming the posterior panel has a gradualstretch until complete extension of the posterior panel.
 11. Theorthopedic device according to claim 1, wherein both the main body paneland the posterior panel are formed from a three-dimensional double facedspacer material having a circular knit.
 12. The orthopedic deviceaccording to claim 1, wherein the main body panel and the posteriorpanel have the same material thickness.
 13. The orthopedic deviceaccording to claim 1, wherein the main body panel and the posteriorpanel are air permeable throughout the entirety of their thickness. 14.The orthopedic device according to claim 1, wherein the material formingthe main body panel and the material forming the posterior panel havesubstantially the same compressibility.
 15. The orthopedic deviceaccording to claim 1, wherein when the orthopedic device is in a rest,unworn condition, the posterior panel is in tension whereas the mainbody panel is generally not in tension.
 16. An orthopedic device,comprising: a main body panel having a longitudinal length with a curvedcross-section, the main body panel having opposed lateral and medialsides; a posterior panel secured to the lateral and medial sides of themain body panel, the posterior panel sized longitudinally shorter thanthe main body panel in a non-stretched condition, the posterior panelspans the longitudinal length of the main body panel along the lateraland medial sides thereof; wherein the main body panel and the posteriorpanel are air permeable throughout the entirety of their thickness. 17.The orthopedic device according to claim 16, wherein the posterior panelurges a bent contour to the posterior side of the orthopedic device. 18.The orthopedic device according to claim 16, wherein the posterior panelhas upper, lower and center portions, the center portion having agreater width than the upper and lower portions.
 19. The orthopedicdevice according to claim 16, wherein longitudinal seams secure theposterior panel to the main body panel, the longitudinal seams beinglocated outside of the center portion of the posterior panel generallycorresponding to the popliteal area of a wearer's leg.
 20. An orthopedicdevice, comprising: an elongate, tubular body adapted to anatomicallyconform to the upper leg, knee and lower leg; first and second hingessecured on lateral and medial sides of the body, the first and secondhinges adjustable in location relative to anterior and posterior sidesof the orthopedic device.